脊髓损伤相关中枢性疼痛与CGRP阳性的初级传入纤维再生的相关性研究  

Relationship between central pain following spinal cord injury and regeneration of CGRP- positive primary afferent fibers

作　　者：林世德[1] 张俊江[1] 臧宇杰 赵廷宝[1] 

机构地区：[1]济南军区总医院脊髓修复科,山东济南250031

出　　处：《中国矫形外科杂志》2016年第24期2274-2279,共6页Orthopedic Journal of China

基　　金：全军医学科技青年培育项目计划(项目编号:13QNP027)

摘　　要：[目的]观察脊髓损伤（spinal cord injury,SCI）后发生中枢性疼痛（central pain,CP）大鼠损伤远端脊髓背角中生长相关蛋白43（GAP-43）和降钙基因相关肽（CGRP）的共定位表达情况,探讨CP与CGRP阳性的初级传入神经纤维出芽再生之间的关系。[方法]SD大鼠16只,随机等分为SCI组和假术（SHAM）组。SCI组大鼠用NYU撞击器损伤L1节段脊髓,撞击力为10 g×12.5 mm。SHAM组大鼠仅切除椎板,不损伤脊髓。术后每天观察双后肢自噬现象,每周测量双后肢运动功能评分（BBB scores,developed by Basso,Beattie and Bresnahan at Ohio State University）。术后4~8周每周测量后肢触压痛痛阈及冷热过敏症状,了解CP的发生情况。术后8周每组取4只行损伤远端脊髓GAP-43与CGRP免疫荧光双标记并在共聚焦显微镜下观察二者的共定位表达情况。[结果]SCI组大鼠术后均出现双后肢瘫痪及明显的CP症状,其损伤远端脊髓背角中GAP-43与CGRP的共定位表达量明显升高,分布范围明显扩大,与SHAM组比较,差异有统计学意义（P〈0.01）。[结论]CP的发生与SCI后感受伤害性刺激的CGRP阳性感觉传入纤维的出芽再生有关。[ Objective] To observe the colocalization of growth - associated protein 43 （ GAP - 43 ） and calcitonin gene - related peptide （CGRP） in the dorsal horns of the distal segments of the spinal cord in rats with central pain （CP） following spinal cord injury （ SCI）, and to investigate the relationship between CP and regeneration of CGRP - positive primary afferent fi- bers. [ Method] A total of 16 Sprague - Dawley rats were randomly and equally divided into SCI group and sham - operation （SHAM） group. The rats in the SCI group were contused at the L1 segment of the spinal cord with an NYU impactor （ impact force 10 g ~ 12.5 mm） ,while those in the SHAM group only underwent laminectomy. The autophagy in both hind limbs was observed every day after injury, and the motor function scores （BBB scores,developed by Basso, Beattie and Bresnahan at Ohio State University） of both hind limbs were measured every week after injury. During 4 -8 weeks after injury, the tenderness threshold and the symptoms of cold and heat hypersensitivity were measured every week to investigate the incidence of CP. At 8 weeks after injury, double - labeling immunofluorescence of GAP - 43 and CGRP in the distal segments of the spinal cord was performed for 4 rats in each group, and confocal microscopy was applied to observe the colocalization of GAP - 43 and CGRP. [ Result] All rats in the SCI group showed paralysis of both hind limbs and obvious CP symptoms, and the SCI group showed sig- nificant increases in the expression and distribution of colocalized GAP - 43 and CGRP in the dorsal horns of the distal segmentsof the spinal cord compared with the SHAM group （ P 〈 0. 01 ）. [ Conclusion ] The pathogenesis of CP is related to the regeneration of CGRP - positive sensory afferent fibers recept- ing nociceptive stimulation after SCI.

关 键 词：脊髓损伤(SCI) 中枢性疼痛(CP) 生长相关蛋白43(GAP-43) 降钙基因相关肽(CGRP) 

分 类 号：R651.2[医药卫生—外科学]